title: Towards the endgame and beyond: complexities and challenges for the elimination of infectious diseases.
abstract: Successful control measures have interrupted the local transmission of human infectious diseases such as measles, malaria and polio, and saved and improved billions of lives. Similarly, control efforts have massively reduced the incidence of many infectious diseases of animals, such as rabies and rinderpest, with positive benefits for human health and livelihoods across the globe. However, disease elimination has proven an elusive goal, with only one human and one animal pathogen globally eradicated. As elimination targets expand to regional and even global levels, hurdles may emerge within the endgame when infections are circulating at very low levels, turning the last mile of these public health marathons into the longest mile. In this theme issue, we bring together recurring challenges that emerge as we move towards elimination, highlighting the unanticipated consequences of particular ecologies and pathologies of infection, and approaches to their management.
authors.affiliation: Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Wilberforce Road, Cambridge CB3 0WA, UK.
authors.forename: Petra
authors.initials: P
authors.lastname: Klepac
authors.forename: C Jessica E
authors.initials: CJ
authors.lastname: Metcalf
authors.forename: Angela R
authors.initials: AR
authors.lastname: McLean
authors.forename: Katie
authors.initials: K
authors.lastname: Hampson
mesh_terms: D003140:Communicable Disease Control / Q000379:methods*; D060740:Disease Eradication / Q000379:methods*; D004198:Disease Susceptibility / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D057131:Immune Evasion / Q000502:physiology*; D032541:Mass Vaccination / Q000706:statistics & numerical data*; D011634:Public Health / Q000379:methods* / Q000639:trends
keywords: immune escape; susceptible build-up; vaccination coverage; vaccine refusal